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What is impetigo?

Impetigo is the most common skin infection among babies and young children (BAD 2017). It causes distinctive blisters or sores, which can be itchy or uncomfortable for your baby.

The infection is caused by bacteria, and is very contagious, but it's unlikely to cause your baby any harm. It usually clears up within a few weeks, and antibiotics can help it clear up faster (NICE 2018).

There are two types of impetigo that can affect your baby, and they have slightly different symptoms (Baddour 2018, NICE 2018):

Non-bullous impetigo

This is the most common type of impetigo (Baddour 2018, NICE 2018). It usually begins with sores around your baby's nose and mouth, which can spread to other areas of her face or body (NICE 2018).

These sores quickly burst, leaving golden brown crusts that can look a bit like cornflakes stuck to your baby's skin (NICE 2018). They usually heal, without scarring, within two or three weeks (NICE 2018).

Non-bullous impetigo is unlikely to be painful for your baby, but it may be uncomfortably itchy (NICE 2018). Your little one isn't likely to have any other symptoms, but in particularly bad cases, she may develop a fever or swollen glands, and feel generally under the weather (Baddour 2018, NICE 2018).

Bullous impetigo

This type of impetigo is less common, though when it does happen, it often affects newborns and babies less than two years old (NICE 2018). It starts with larger blisters (up to 2cm across) around your baby's skin folds – such as elbows, knees, armpits and nappy area - or her face, chest, arms or legs (NICE 2018).

The blisters last for about two or three days before bursting, leaving a yellow-brown crust (NICE 2018). This gradually heals, without scarring, over the course of about two or three weeks (NICE 2018).

Bullous impetigo is more likely to be painful for your baby, so you may notice she's more irritable than usual (NICE 2018). If she has this type of impetigo, she's also more likely to develop other symptoms, such as a fever, swollen glands, diarrhoea, and feeling generally unwell (NICE 2018).

How did my baby get impetigo?

The bacteria that cause impetigo are highly contagious, so your baby could have caught it by touching someone who has it, or by sharing toys, clothes or towels with them (NICE 2018).

It's particularly easy for your baby to catch impetigo if she has broken skin, for example due to an insect bite, or an existing skin condition such as eczema (NICE 2018). It also spreads more easily in hot and humid weather (NICE 2018).

How can my baby’s impetigo be treated?

If you think your baby could have impetigo, see your GP. In most cases, he'll prescribe an antibiotic cream to speed up the healing process and help your little one feel better, sooner (NHS 2018, NICE 2018).

If your baby’s impetigo is severe or widespread, your doctor may prescribe antibiotic liquid for you to give her by mouth (NHS 2018, NICE 2018). Give your baby the full course of antibiotics, even if her symptoms clear up quickly (NHS 2017, NHS 2018). This will help to prevent the infection from returning or becoming resistant to the antibiotics (NHS 2017).

With antibiotic treatment, your baby's impetigo should clear up within a week to 10 days (NHS 2018). If her symptoms don't start to improve within five days of starting treatment, take her back to your GP. He'll check to see whether it's definitely impetigo, and may prescribe a different type of medicine (NICE 2018).

Sometimes, impetigo keeps coming back (NHS 2018, NICE 2018). If this happens to your baby, tell your GP. He may offer to take a swab from her nose, to see if she's carrying a certain type of bacteria (NHS 2018, NICE 2018). If so, your GP may prescribe an antiseptic cream that you can use around her nose to reduce the risk of impetigo coming back again (NHS 2018).

In rare cases, impetigo can develop into a more serious skin condition (cellulitis), or another potentially serious illness such as septicaemia or scarlet fever (NICE 2018). If your baby seems to be getting worse, or you have any concerns about her symptoms, call 111 for urgent advice (NHS 2018) (in Wales call 0845 46 47, and in Northern Ireland call your local GP surgery to find your out-of-hours service).

How can I care for my baby while she has impetigo?

Because impetigo is so infectious, you'll need to keep your baby home from nursery or childcare (NHS 2018, NICE 2018). She can usually go back after she's been treated with antibiotics for 48 hours (NHS 2018, NICE 2018), but check with your childcare provider first.

If your baby isn't able to take antibiotics, she'll need to stay home until all the sores or blisters have dried out and crusted over (NHS 2018, NICE 2018).

While you're waiting for your baby's impetigo to clear up, the following tips will help to promote healing and reduce the risk of the infection spreading:

Cover the sores with loose clothing or bandages to prevent your baby scratching and reduce the risk of the infection spreading (NHS 2018).

Avoid touching the sore areas as much as possible (BAD 2017, NHS 2018). Wash your hands often, particularly before and after applying any antibiotic cream (BAD 2017), and after any time you accidentally touch the sores (BAD 2017, NICE 2018).

Try to discourage your baby from scratching her sores (NHS 2018, NICE 2018), and keep her nails trimmed and clean to reduce any damage to her skin when she does scratch (Harding 2016). You could also consider using anti-scratch mittens.

Keep your baby’s flannel, towels, sheets, clothes and soft toys separate from those used by other family members (NHS 2018, NICE 2018). Wash them on a hot wash after your baby has used them (BAD 2017, NHS 2018)

Wipe down plastic or wooden toys with detergent and warm water after your baby has touched them (NHS 2018).

Following these hygiene measures will help to protect the rest of your family while your baby has impetigo. In most cases, your little one will be back to her normal self within a week to 10 days of starting treatment.

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